Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 Factors Affecting Mortality Rate Regarding Covid-19 Pandemic 225 226 EN Sara Emamgholipour Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran N Shahab Parvizi Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran parvizishahab83@gmail.com Y 10.18502/jebhpme.v6i4.11534 This article has no abstract. Covid-19, Risk management, Aging, vaccination http://jebhpme.ssu.ac.ir/article-1-381-en.html http://jebhpme.ssu.ac.ir/article-1-381-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 Success Rate of Strategic Planning: A Case Study of a Medical Science Uni-versity in Southeast Iran 227 234 EN Parvaneh Isfahani Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran N Mahnaz Afshari Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran Mahnazafshar89@gmail.com Y Adnan Miri Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran N Ehsan Shanavazi Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran N Marzieh Arefy Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran N Javad Shahreki Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran N 10.18502/jebhpme.v6i4.11535 Background: Successful implementation of strategic planning can can play an important role in improving the performance of organizations. This study aims to determine the success rate of strategic planning at a Medical Science University in Southeast Iran. Methods: This descriptive-analytical study conducted at the Zabol University of Medical Science in southeast Iran in 2018. 168 top-level, middle-level, operational managers and employees were involved in the strategic planning process. They were randomly selected by stratified sampling method. Data were collected using a standard questionnaire and analyzed by proper statistical tests in SPSS19 software. Results: Strategic planning implementation was moderately successful at Zabol University of medical science ( score 2/99 out of 5). The highest success was observed for leadership and management, planning dimensions, and the least belonged to the domains of employees' management and organizational learning. Leadership and management, planning, and organizational culture constructs had the greatest effect on the success of strategic plans. Conclusion: The success rate of strategic planning at this university was average. Therefore, health managers and policymakers must take action for its successful implementation in universities.   Strategic planning, Success, University, Iran http://jebhpme.ssu.ac.ir/article-1-402-en.html http://jebhpme.ssu.ac.ir/article-1-402-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 Path Analysis of Critical Thinking Effect on Self-Efficiency Among Nursing and Medical Students 235 244 EN Omid Khosravizadeh Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran N Bahman Ahadinezhad Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran N Aisa Maleki Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran AisaMalekii@gmail.com Y Ailar Hashtroodi Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran N Pariya Vosoughi Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran N Shahrzad Kohan Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran N 10.18502/jebhpme.v6i4.11536 Background: Critical thinking is the ability to ask appropriate questions and gather relevant information. It enables rational judgment and problem-solving for physicians and nurses. For the first time, this study examined two major groups of caregivers at the patient's bedside in terms of the relationship between critical thinking and self-efficacy. Methods: This was a descriptive-analytical and cross-sectional study conducted in 2021. The sample was taken from QUMS’s nursing and medical students through stratified random method. It was performed using structural equation method (n=377). Data collection tools included: demographic information, Ricketts critical thinking questionnaire, and GSE-17 questionnaire. Finally, data were analyzed through the correlation coefficient and multiple regression tests using SPSS22 software at a significance level of 0.05. Results: Results indicated that the model established at this step demonstrates good fitness. In this model χ2 = 1919.91, df = 89, χ2 / df = 2.14, RMSEA = 0.05, NFI = 0.63, GFI = 0. 77 and CFI = 0. 76.   The structural equation model's standard estimation coefficients show that all the existing paths are at a significant level (CTH: CRV 0.96, CTH: COM 0.94, CTH: SFE -0.61; P-value< 0.05). Finally, the regression analysis showed an inverse effect of critical thinking on self – efficacy. Conclusion: The study showed that critical thinking had a direct effect on self-efficacy. In addition, these two features have a significant effect on increasing the efficiency and making the right clinical decisions in medical and nursing groups. Therefore, upgrading these skills by updating curriculum will ultimately improve healthcare outcomes provided by these two specific groups.   Critical thinking, Self-efficiency, Path analysis http://jebhpme.ssu.ac.ir/article-1-389-en.html http://jebhpme.ssu.ac.ir/article-1-389-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 The Effect of COVID-19 Pandemic and the Development of Technology and Robots on Jobs 245 250 EN Ali Masoud Department of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran N Reza Dehnavieh Department of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran rdehnavi@gmail.com Y Vahid Yazdi Feyzabadi Department of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran N Sara Poursheikhali Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran N Somayeh Noori Hekmat Department of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran N Mina Ghasemi Moghadam Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran N Mohammad Kazemi Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran N 10.18502/jebhpme.v6i4.11537 Background: The prevalence of COVID-19 has had a devastating economic impact on countries, leading to reduction of many jobs. Earlier, the advent of technology and robotics had been the source of much concern and analysis about the future of jobs. The present study aims to investigate the effects of the COVID-19 pandemic and the emergence and development of technology and robots on jobs and compare them with each other. Methods: The present study was conducted qualitatively. Data collection was done by holding two expert panels. The experts were purposefully selected from different universities in Iran. Findings from the expert panel were analyzed using the content analysis technique. Erlingsson's approach was used for content analysis. Results: The effects of the advent of technology and robots and the effects of the COVID-19 outbreak on jobs were examined from seven aspects, including economic, social, political, the impact on developed and developing countries, health, education, and workforce skills. The effects of the advent of technology and robots on jobs can vary depending on the two scenarios of interaction or substitution. The effects of the COVID-19 outbreak on jobs can also be in line with different scenarios with the emergence of technology and robots in some respects. Conclusion: The possible conformity of economic and social systems in gradual changes faces fewer challenges, while conditions like pandemics have few opportunities to adapt to new situations. Increasing flexibility with a preemptive approach and not just based on the existing scenarios are necessary to deal with these situations. Robot, COVID-19, Coronavirus, Future, Job http://jebhpme.ssu.ac.ir/article-1-398-en.html http://jebhpme.ssu.ac.ir/article-1-398-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 Evaluating Conditions of Outsourced Pharmacies in Teaching Hospitals of Alborz University of Medical Sciences: A Cross-Sectional Study 251 261 EN Roya Rajaee Department of Health Service Management, School of Public Health, Alborz University of Medical Sciences, Alborz, Iran rajaeeroya@ymail.com Y Sima Marzban Department of Chief Executive Officer(CEO), Key Patient Insights, Chapel Hill, North Carolina N Ehsan Zarei Department of Health Service Management, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran N 10.18502/jebhpme.v6i4.11538 Background: Outsourcing is the strategy of reducing expenses and improving organizational quality whose evaluation in healthcare organizations is of special importance. This study aims to investigate the status of outsourced pharmacies of Alborz University of Medical Sciences based on personnel perspectives and available documentation. Methods: This was a descriptive analytical and cross-sectional study conducted in outsourced pharmacies of 10 teaching hospitals of Alborz University of Medical Sciences. Expenses, revenues and working time were derived from the hospitals’ information centers and the documents. 128 relevant officials were selected by census to investigate the views of managers and authorities of clinical wards on outsourcing. Authors analyzed data using descriptive statistics, t-test and chi-square test through SPSS22 software. All cost was converted to US dollar by using the average exchange rate in 2019 (1USD=110.000IR). Results: The average satisfaction of managers and staff with outsourcing pharmacies were 4.20 (82 %) and 4.45 (80 %) out of 5. The highest level belonged to medicine expiration date with the average of 4.64, and the lowest score was related to medicinal status at the time of delivery with the average of 4. Consumption expenses for a bed in outsourced pharmacies regarding all the hospitals were 123 $, and the profitability of the pharmacy for one bed was134 $ (5.540.900 Riyals). Conclusion: Based on the results, the following components had a relatively proper quality and an acceptable quality in all the respects of the staff’s view regarding the conditions in the pharmacies. They can be inferred as the most salient characteristics of the present study in investigating the quality of outsourcing the pharmacies of the teaching hospitals in Alborz medical sciences. The important components include: The time spent by executive managers of the pharmacy’s affairs, decrease of the manager’s workload, improvement of management, increase in management’s satisfaction in the organization and etc.  Hospital, Outsourcing, Effectiveness, Pharmacy, Reducing expense http://jebhpme.ssu.ac.ir/article-1-405-en.html http://jebhpme.ssu.ac.ir/article-1-405-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 The Effects of Policy Change Regarding Health Expenditures on Households Behavior 262 272 EN Hamidreza Izadi Department of Economics, Faculty of Management and Humanities, Chabahar Maritime University, Chabahar, Iran izadi@cmu.ac.ir Y 10.18502/jebhpme.v6i4.11539 Background: In order to assess households' socioeconomic level in society, policymakers and government planners nowadays pay close attention to families' access to health services. They calculate the percentage of a household's bundle of consumer goods and services. In this regard, the current study examines and analyzes the household's behavior as a result of the government's policies in changing and determining the share of the household's health expenses from its total consumption expenses. This is to ensure that society is kept at a minimum level of health. Methods: In order to accurately execute health policies and change household behavior, this research studies the share and access of Iranian households to health products and services. The author used a Dynamic Stochastic General Equilibrium model through quarterly data from 1997 to 2020. Results: Findings show that as this share increased, other items' consumption and utility decreased, which ultimately led to a fall in society's total utility according to the definition that utility is a term used as a measure of pleasure or happiness resulting from consuming goods and services. Conclusion: The government and policymakers need to bear some of health expenditures and provide financial support to households until it reaches the desired level. This is to prevent a significant decrease in the level of total utility in society. This decrease is brought on by people's dissatisfaction with spending a larger portion of their expenses on health goods and services. Health expenditures, Households’ behavior, Policy, Changes http://jebhpme.ssu.ac.ir/article-1-409-en.html http://jebhpme.ssu.ac.ir/article-1-409-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 Strategies for Reducing Induced Demand in Hospitals Affiliated with Iran University of Medical Sciences: A Qualitative Study 273 284 EN Hesam Seyedin Department of Health Services Management, School of Health Management and Information Sciences, Iran Universi-ty of Medical Sciences, Tehran, Iran N Mahnaz Afshari Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran, Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran N Parvaneh Isfahani Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran N Ebrahim Hasanzadeh Department of Health Services Management, School of Health Management and Information Sciences, Iran Universi-ty of Medical Sciences, Tehran, Iran N Maryam Radinmanesh Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medi-cal Sciences, Tehran, Iran N Rasoul Corani Bahador Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran rasoul.bahador@gmail.com Y 10.18502/jebhpme.v6i4.11540 Background: Induced demand is a major challenge for health systems worldwide. It increases costs, especially for patients. The purpose of this study is to identify strategies for reducing induced demand for health care in hospitals affiliated with the Iran University of Medical Sciences (IUMS). Methods: This was a qualitative study conducted in 2018. The authors conducted in-depth, semi-structured interviews with 20 participants, including IUMS faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze data. Data analysis was performed in MAXQDA10. Results: Overall,  the authors extracted 24 subthemes from the interviews and classified them into the health system, insurer, healthcare provider, and healthcare recipient. They are key factors regarding the induced demand for healthcare in the public hospitals under study. Conclusion: Reducing induced demand for healthcare requires concerted actions by health policymakers and managers at the level of the health system, insurers, healthcare providers, and healthcare recipients. Therefore, policymakers and managers of the health system should take appropriate measures such as the development of guidelines and protocols by different departments, especially the emergency department, classification (primary, secondary, and tertiary care), and referral system. They expand the monitoring role of insurance companies (transforming the payment system into the global diagnosis-related group)  to reduce the induced demand for health.  Induced demand, Hospital, Strategy http://jebhpme.ssu.ac.ir/article-1-407-en.html http://jebhpme.ssu.ac.ir/article-1-407-en.pdf

Shahid Sadoughi University of Medical Sciences Evidence Based Health Policy, Management and Economics 2538-5070 2538-4716 6 4 2022 10 1 Challenges of Performance-Based Payment Methods in Health Care System: A Systematic Review 285 297 EN Seyed Mehdi Paknejad Rizi Department of Healthcare Services Management, School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran N Fatemeh Torabi Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran fatemehtorabi1374@gmail.com Y Hamideh Jafari Pavarsi Department of Digital library, The Special Library of the Academy of Art, Tehran, Iran N 10.18502/jebhpme.v6i4.11541 Background: Performance-based payment refers to an incentive-based payment to employees in terms of and beyond their job requirements at an extremely high quality. Therefore, this study aims to review the challenges of performance-based payment in the healthcare system. Methods: The study was carried out as a systematic review through searching databases, i.e., PubMed, Web of Science, and Scopus, for articles published without time limitation to September 30, 2020. The research articles regarding Performance-based payment in hospitals (n = 16) were examined. Results: Generally, challenges of performance-based payment were divided into four main categories and 17 subcategories, including service providers, payment and financing, quality of provided services, and infrastructure. The main themes and sub-themes were related to the lack of financial resources, discrimination between patients, and the designing of a comprehensive information system. Conclusion: Suitable implementation of performance-based payment methods in the healthcare system will improve quantitative and qualitative indicators of staff performance. Identifying the challenges and obstacles to the proper implementation of this plan will help health managers and policymakers design and implement remedial measures. It is to reduce the barriers and problems.   Performance-based payment, Payment system, Health system, Challenge http://jebhpme.ssu.ac.ir/article-1-383-en.html http://jebhpme.ssu.ac.ir/article-1-383-en.pdf